We can’t keep absorbing the cost”: The growing gap between care delivery and commissioner funding

 

 

A resident’s needs increase.

Staffing levels rise.

Agency use increases.

Night support becomes more intensive.

Behaviours escalate.

Clinical oversight becomes more frequent.

But the funding stays exactly the same!

 

For many adult social care providers, this is now one of the biggest operational tensions in the sector: the widening gap between the actual cost of delivering care and the funding attached to placements and contracts.

Providers are increasingly finding themselves carrying financial risk that was never intended to sit solely with them.

Care England and Hempsons will explore these pressures during a webinar on 9 June focused on commissioner funding disputes, procurement challenges and practical approaches to protecting service sustainability.

Many funding disputes do not begin as disputes at all. They begin with providers trying to “manage” increasing pressure internally. A home absorbs additional staffing costs for several months while waiting for reassessment. A provider delays raising concerns because they fear damaging commissioner relationships. A service continues accepting placements despite rates no longer reflecting complexity because occupancy pressures leave little alternative.

Over time, these become structural financial pressures which undermine sustainability, workforce stability and ultimately the provider’s ability to invest in quality and innovation. Providers often describe feeling trapped between operational reality and contractual limitations.

One of the biggest changes facing providers is the increasing complexity of care being delivered. Care homes are supporting people with higher acuity, multiple co-morbidities, dementia-related distress, frailty, behavioural challenges and increasingly complex discharge pathways from hospitals.

Yet funding models and procurement frameworks do not always evolve at the same pace as care needs.

 

This creates tension around:

• Enhanced staffing requirements
• One-to-one support
• Specialist equipment
• Workforce skills and competency
• Behavioural support needs
• Clinical oversight
• Risk management requirements

Without robust review processes and evidence-led conversations, providers can quickly find themselves delivering care significantly beyond the assumptions underpinning the original funding arrangement.

One of the key messages from the upcoming webinar is the importance of early intervention. Providers often wait too long before escalating concerns or seeking advice, by which point relationships may already have deteriorated and financial losses become difficult to recover.

 

The session will explore:

• How providers can better evidence cost pressures
• The importance of understanding contract wording
• What commissioners are required to consider
• How procurement and framework processes operate
• What practical negotiation looks like in reality
• When formal challenge may become necessary
• How to avoid disputes escalating unnecessarily

The aim is not confrontation. Most providers want collaborative relationships with commissioners and understand the pressures local authorities and ICBs are facing.

However, collaboration only works when providers understand their position, communicate concerns clearly and have confidence in the processes available to them. Building sustainability rather than crisis management

But sustainable care services cannot be built on providers continually absorbing unfunded pressure, delaying difficult conversations or carrying risk indefinitely.

This webinar is intended to help providers better understand the commissioning environment they are operating within and equip them with practical approaches to managing disputes, protecting viability and supporting long-term sustainability.

For providers currently navigating fee disputes, unclear contracts, reassessments or commissioning pressures, this session will provide practical insight into how others are approaching these challenges and where early action can make a meaningful difference.

 

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Join the Hempsons webinar

This webinar aims to help providers build that confidence before issues become crises.

Join Care England and Hempsons on 9th June for a practical discussion on commissioner funding disputes, procurement challenges and protecting service sustainability in an increasingly complex operating environment.